[Acute retinal necrosis in an acute leukemia pediatric patient]

Area of Science:

• Ophthalmology
• Virology
• Pediatric Oncology

Background:

• Acute retinal necrosis (ARN) is a severe ocular condition usually affecting immunocompromised adults.
• ARN is often associated with the reactivation of herpes simplex virus or varicella-zoster virus.
• High-risk acute leukemia patients undergoing intense chemotherapy are particularly vulnerable to opportunistic infections.

Observation:

• A 4-year-old patient with high-risk acute leukemia developed chickenpox with visceral involvement during chemotherapy.
• The varicella-zoster virus infection led to unilateral blindness in the affected child.
• Varicella-zoster virus was identified in the vitreous humor via PCR, despite prior acyclovir treatment.

Findings:

• The case demonstrates a rare occurrence of ARN in a pediatric patient with acute leukemia.
• Varicella-zoster virus was confirmed as the causative agent of ARN in this immunocompromised child.
• Despite treatment, the viral infection resulted in severe, unilateral vision loss.

Implications:

• This case underscores the importance of vigilant monitoring for opportunistic infections in pediatric leukemia patients.
• Early detection and aggressive management of viral retinitis are crucial to prevent vision loss in immunocompromised children.
• Understanding ARN pathogenesis in pediatric oncology may inform future treatment strategies and preventative measures.